Cranial Cruciate Ligament

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Cranial Cruciate Ligament (CCL) Injuries

The cranial cruciate ligament (CCL) is a primary ligament in the knee. In humans, the CCL is known as the anterior cruciate ligament (ACL). The ligament helps hold the knee in place, supporting a pet’s weight, preventing hyperextension of the knee and keeping the femur from sliding against the tibia. Because there is constant tension on the CCL, it’s highly vulnerable to injury. Ruptured CCLs are one of the most common orthopedic injuries affecting our dogs, and it’s particularly common in large breeds. Our pets can rupture their CCLs from ligament deterioration or traumatic injury, and once a CCL is ruptured, the knee is unable to bear weight. CCL ruptures dramatically reduce your pet’s mobility. If left untreated, CCL tears can lead to osteoarthritis and meniscus damage.

There are several surgical options for repairing CCL ruptures. Two common methods we perform at Dana Niguel Veterinary Hospital are extracapsular repair and tibial-plateau-leveling osteotomy.

Extracapsular Repair

Depending on the severity of the tear and the pet’s general health, extracapsular repair may be the most effective method for repairing a torn CCL. This procedure can be performed on any dog, but we most often recommended it for smaller breeds and senior dogs.

During extracapsular repair procedures, we use a robust suture material to recreate the cranial cruciate ligament, securely binding the two torn halves together. Over the several months following the procedure, scar tissue develops along the suture, reinforcing the repair and stabilizing the knee. While extracapsular repair is not the sturdiest repair method available, the surgery is highly effective for smaller and less active pets. It also generally results in fewer complications compared to other CCL repair procedures.

Tibial-Plateau-Leveling Osteotomy (TPLO)

Tibial-plateau-leveling osteotomy (TPLO) is an advanced surgical procedure used to repair the cranial cruciate ligament (CCL). The procedure involves restructuring how bones interact within the knee to restabilize the joint. This innovative surgery alters the slope of the tibia to allow the femur to rest directly on the bone. During surgery, the surgeon cuts the upper section of the tibia and rotates the bone until the plateau is level. A steel plate is then attached to the bone to hold it in place and allow the bone to heal correctly. By leveling the tibial plateau, the femur is no longer able to slide against the bone and cause damage. This means a load-bearing, stable joint is created without the cranial cruciate ligament.

Recovering from Extracapsular Repair and TPLO

Extracapsular repair and TPLO are major procedures, and no matter which your pet receives, a 12-week recovery period is required after surgery. We prescribe painkillers, anti-inflammatory medications and antibiotics following extracapsular repairs and TPLO procedures to minimize pain and prevent infection of the incision. Pets that are prone to licking wounds must wear a collar to prevent bacteria from entering the bloodstream.

During this crucial recovery period, exercise must be limited to allow the bone and soft tissues to heal. To restrict unnecessary movement and prevent pets from doing any strenuous activity, keep recovering pets confined to a small area in the home. We will conduct regular veterinary checkups, including X-rays, to monitor recovery and assess limb and joint function and general mobility. Your Dana Niguel veterinarian may recommend a gradual increase of exercise on a case-by-case basis.

We generally recommend to begin physical therapy around four weeks after surgery. This rehabilitation often includes strength training, range of motion techniques and aquatic therapy to strengthen the joint and restore mobility.

Think your pet may be suffering from a torn CCL? Schedule a consultation at Dana Niguel Veterinary Hospital by calling 949-558-3646.

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